Does immunohistochemical staining have a clinical impact in early gastric cancer conducted endoscopic submucosal dissection?

doi:10.3748/wjg.v18.i33.4578

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 18, Issue 33

This Article

Citation of this article

Corresponding Author of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (2723)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-1) series, Tables (1-5) series.

Item

Count

PDF

323

HTML

2104

Figures (1-1)

160

Tables (1-5)

136

Sum=2723

Sep 7, 2012 (publication date) through Apr 24, 2024

Times Cited of This Article

Times Cited (5)

Journal Information of This Article

Publication Name

World Journal of Gastroenterology

ISSN

1007-9327

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Brief Article

World J Gastroenterol. Sep 7, 2012; 18(33): 4578-4584
Published online Sep 7, 2012. doi: 10.3748/wjg.v18.i33.4578

Table 1 Endoscopic and pathologic characteristics of endoscopic submucosal dissection groups

Groups	Absolute (n = 100)	Expanded (n = 248)	P value
Age (yr), mean (range)	62.2 (33-86)	62.9 (33-91)	0.589
Male (%)	70 (70)	189 (76.2)	0.277
Location (%)			0.183
Upper	3 (3)	21 (8.5)
Middle	31 (31)	69 (27.8)
Lower	66 (66)	158 (63.7)
Macroscopic type (%)			< 0.001
Elevated	59 (59)	56 (22.6)
Flat/depressed	36 (36)	131 (52.8)
Mixed	5 (5)	61 (24.6)
Endoscopic ulcer (%)			< 0.001
Present	0 (0)	161 (64.9)
Absent	100 (100)	87 (35.1)
Resection (%)			0.053
En-bloc	100 (100)	234 (94.4)
Complete reconstruction	0 (0)	8 (3.2)
≥ 3 piecemeal	0 (0)	6 (2.4)
Histology (%)			0.069
Differentiated	100 (100)	238 (96)
Undifferentiated	0 (0)	10 (4)
Depth (%)			< 0.001
M2	59 (59)	89 (35.9)
M3	41 (41)	131 (52.8)
SM1	0 (0)	28 (11.3)
Tumor size (mean, range)	11.4 (2-20)	21.2 (3-86)	< 0.001
≤ 20 mm (%)	100 (100)	131 (52.8)
> 20 mm (%)	0 (0)	117 (47.2)
Lateral margin (%)			< 0.001
Positive	0 (0)	24 (9.7)
Negative	100 (100)	224 (90.3)
Vertical margin (%)			0.500
Positive	0 (0)	2 (0.8)
Negative	100 (100)	246 (99.2)
Phenotype (%)			0.312
Gastric	24 (24)	66 (26.6)
Intestinal	31 (31)	92 (37)
Mixed	45 (45)	90 (36.3)
VEGF (%)			0.096
Positive	79 (79)	72 (29)
Negative	21 (21)	176 (71)
High MVD/LVD (%)			0.116
Positive	16 (16)	59 (23.8)
Negative	84 (84)	189 (76.2)
LVI HES			0.713
Positive	0 (0)	1 (0.4)
Negative	100 (100)	247 (99.6)
LVI IHCS			0.038
Positive	0 (0)	11 (4.4)
Negative	100 (100)	237 (95.6)

M: Mucosa; SM: Submucosa; VEGF: Vascular endothelial growth factor; MVD: Microvessel density; LVD: Lymphatic vessel density; LVI: Lymphovascular invasion; HES: Hematoxylin-eosin staining; IHCS: Immunohistochemical staining.

Table 2 Subgroup analysis in the expanded indication groups

	Group 1 (n = 71)	Group 2 (n = 140)	Group 3 (n = 27)	Group 4 (n = 10)	P value
Age > 60 (yr, %)	44 (62)	82 (58.6)	21 (77.8)	6 (60)	0.502
Male (%)	56 (78.9)	104 (74.3)	24 (88.9)	5 (50)	0.455
Location (%)					0.730
Upper + corpus	19 (26.8)	15 (10.7)	11 (40.7)	1 (10)
Lower + angle	52 (73.2)	125 (89.3)	16 (59.3)	9 (90)
Macroscopic type (%)					< 0.001
Elevated	45 (63.4)	4 (2.9)	4 (14.8)	3 (30)
Flat/depressed	26 (36.6)	136 (97.1)	23 (85.2)	7 (70)
Endoscopic ulcer (%)					< 0.001
Present	0 (0)	140 (100)	20 (74.1)	1 (10)
Absent	71 (100)	0 (0)	7 (25.9)	9 (90)
Resection, piece (%)					0.177
≤ 2	68 (95.8)	137 (97.9)	27 (100)	10 (100)
≥ 3	3 (4.2)	3 (2.1)	0 (0)	0 (0)
Depth (%)					0.003
M2	33 (46.5)	52 (37.1)	0 (0)	4 (40)
M3 + SM1	38 (53.5)	88 (62.9)	27 (100)	6 (60)
Tumor size, mm (%)					< 0.001
≤ 20	0 (0)	105 (75)	16 (59.3)	10 (100)
> 20	71(100)	35 (25)	11 (40.7)	0 (0)
Lateral margin (%)					0.091
Positive	10 (14.1)	11 (7.9)	1 (3.7)	2 (20)
Negative	61 (85.9)	129 (92.1)	26 (96.3)	8 (80)
Vertical margin (%)					0.170
Positive	2 (2.8)	0 (0)	0 (0)	0 (0)
Negative	69 (97.2)	140 (100)	27 (100)	10 (100)
Phenotype (%)					0.107
Intestinal	31 (43.7)	50 (35.7)	9 (33.3)	2 (20)
Non-intestinal	40 (56.3)	90 (64.3)	18 (66.7)	8 (80)
VEGF (%)					0.003
Positive	17 (23.9)	34 (24.3)	16 (59.3)	5 (50)
Negative	54 (76.1)	106 (75.7)	11 (40.7)	5 (50)
High LVD/MVD (%)					< 0.001
Positive	11 (15.5)	26 (18.6)	16 (59.3)	6 (60)
Negative	60 (84.5)	114 (81.4)	11 (40.7)	4 (40)
LVI HES					0.005
Positive	0 (0)	0 (0)	0 (0)	1 (10)
Negative	71 (100)	140 (100)	27 (100)	9 (90)
LVI IHCS					< 0.001
Positive	1 (1.4)	1 (0.7)	7 (25.9)	2 (20)
Negative	70 (98.6)	139 (99.3)	20 (74.1)	8 (80)

Table 3 Comparison of lymphovascular invasion hematoxylin-eosin staining and lymphovascular invasion immunohistochemical staining groups

ESD indication			LVI IHCS		Total	P value
ESD indication			Negative	Positive		P value
Absolute	LVI HES	Negative	100	0	Total	100
Absolute	LVI HES	Positive	0	0	0
	Total		100	0	100
Expanded	LVI HES	Negative	237	10	247	0.044
Expanded	LVI HES	Positive	0	1	1 (0.4%)
	Total		237	11 (4.4%)	248

ESD: Endoscopic submucosal dissection; LVI: Lymphovascular invasion; HES: Hematoxylin-eosin staining; IHCS: Immunohistochemical staining.

Table 4 Comparison of lymphovascular invasion by immunohistochemical stain negative and positive group

	LVI IHCS		P value
	Negative (n = 237)	Positive (n = 11)
Age, yr (%)	62.6 ± 9.9	69.4 ± 10.2	P value	0.054
≤ 60	92 (38.8)	3 (27.3)
> 60	145 (61.2)	8 (72.7)
Male (%)	182 (76.8)	7 (63.6)	0.297
Location (%)			0.667
Upper + corpus	44 (18.6)	2 (18.2)
Lower + angle	193 (81.4)	9 (81.8)
Macroscopic type (%)			0.715
Elevated	53 (22.4)	3 (27.3)
Flat/depressed	184 (77.6)	8 (72.7)
Endoscopic ulcer (%)			0.524
Present	155 (65.4)	6 (54.5)
Absent	82 (34.6)	5 (45.5)
Resection, piece (%)			0.760
≤ 2	231 (97.5)	11 (100)
≥ 3	6 (2.5)	0 (0.0)
Histology (%)			0.066
Differentiated	229 (96.6)	9 (81.8)
Undifferentiated	8 (3.4)	2 (18.2)
Depth (%)			0.009
M2	89 (37.6)	0 (0)
M3 + SM1	148 (62.4)	11 (100)
Tumor size, mm (%)	21.2 ± 12.8	21.2 ± 16.7	0.986
≤ 20	125 (52.7)	6 (54.5)
> 20	112 (47.3)	5 (45.5)
Lateral margin (%)			0.289
Positive	22 (9.3)	2 (18.2)
Negative	215 (90.7)	9 (81.8)
Vertical margin (%)			0.913
Positive	2 (0.8)	0 (0)
Negative	235 (99.2)	11 (100)
Phenotype (%)			0.751
Intestinal	89 (37.6)	3 (27.3)
Non-intestinal	148 (62.4)	8 (72.7)
VEGF (%)			< 0.001
Positive	62 (26.2)	10 (90.9)
Negative	175 (73.8)	1 (9.1)
High LVD/MVD (%)			< 0.001
Positive	48 (20.3)	11 (100)
Negative	189 (79.7)	0 (0.0)

IHCS: Immunohistochemical staining; M: Mucosa; SM: Submucosa; VEGF: Vascular endothelial growth factor; LVD: Lymphatic vessel density, MVD: Microvessel density.

Table 5 Clinicopathological characteristics of the five patients who underwent surgical resection after endoscopic submucosal dissection

Sex/age (yr)	Type	Site	Ulcer	Pathology	Size (mm)	LM/VM	Depth	LVI HES	LVI IHCS	Residual tumor	LN
Female/67	IIc	Lower	-	MD	30	-/+	M	-	-	+	-
Male/74	III	Middle	+	WD	14	+/-	M	+	+	-	-
Female/64	III	Middle	+	MD	19	+/-	M	-	-	-	-
Female/54	I	Middle	-	MD	68	+/-	M	-	+	+	-
Male/35	I	Middle	-	MD	22	-/-	M	-	-	-	-

LM: Lateral margin; VM: Vertical margin; LVI: Lymphovascular invasion; HES: Hematoxylin-eosin staining; IHCS: Immunohistochemical staining; LN: Lymph node; MD: Moderately differentiated; WD: Well differentiated; M: Mucosa.

Citation: Jeon SR, Cho JY, Bok GH, Lee TH, Kim HG, Cho WY, Jin SY, Kim YS. Does immunohistochemical staining have a clinical impact in early gastric cancer conducted endoscopic submucosal dissection? World J Gastroenterol 2012; 18(33): 4578-4584
URL: https://www.wjgnet.com/1007-9327/full/v18/i33/4578.htm
DOI: https://dx.doi.org/10.3748/wjg.v18.i33.4578